Spraakontwikkelingsstoornissen: Van symptoom- naar procesdiagnostiek

Speech disorders are estimated to form about 75% of all communication disorders in children. The majority of these children are seen by speech therapists for diagnosis and treatment. A variety of methods of intervention has been developed, aimed at different parts of the speech production process. However, the diagnostic instruments that are currently available consist of tests that measure knowledge and skills. This results in a behavioural (=symptom) description, on which the clinician bases diagnostic classification, treatment program and referral to special education. The current paper advocates the implementation of process-oriented diagnostics and treatment planning in clinical practice. Recent research into the mechanisms behind childhood speech disorders has yielded important insight into the relation between underlying deficits, compensatory adaptations and how these express themselves in symptomatology. The acquired knowledge comprises a wide range of methods for investigating speech production and perception, and the relation between production and perception, forming a solid theoretical basis for an approach based on diagnosing the processes involved in each individual case. This individualistic, process-oriented approach can be achieved through objective measurements of speech production in systematically varied speech tasks under systematically varied conditions and holds important advantages for the diagnosis and treatment of paediatric speech disorders.